Gum Disease and Complications during Pregnancy

So far, your pregnancy weight gain is healthy, you’re eating nutritious foods, exercising regularly, and you haven’t missed a prenatal checkup. It seems you’ve got it all covered, right? Well, maybe not. Have you seen your dentist recently? A significant risk factor for your baby’s health may be lurking in a surprising place—your smile.

Periodontal disease, a condition that affects over 35 million Americans, has been linked to complications during pregnancy. Many women aren’t aware of the potential risks associated with oral infections. Taking the time to educate yourself about periodontal disease and treatment is a valuable investment in your health, as well as the health of your unborn baby.

What is Periodontal Disease?

Periodontal disease, commonly known as gum disease, is a chronic bacterial infection that affects the tissues that surround the teeth, including the gums and bones supporting the teeth. According to the American Dental Association (ADA), gum diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss.

Periodontal disease begins when the bacteria in plaque—the sticky, colorless film that constantly forms on your teeth—causes the gums to become inflamed. If the bacteria grow unchecked and the infection of the gums spreads, your teeth could become loose, fall out, or need to be extracted. But the dangers associated with gum disease become vastly more important for expectant moms.

Pregnancy Risks Associated with Gum Disease

Several recent studies published in the Journal of Periodontology have found a strong link between gum disease and pregnancy complications. Dr. Steven Offenbacher, a professor at the University of North Carolina School of Dentistry and an expert on periodontal disease and pregnancy, says these studies have “shown that mothers who have periodontal disease are more likely to have pregnancy complications. Particularly, it increases the risk of preterm delivery and babies with low birth weight.”

Women with gum disease are at an increased risk of delivering at less than 37 weeks of gestation, says Dr. Offenbacher, stressing that the medical community is not yet sure exactly why this is. “It seems to be independent of traditional obstetric risk factors; we’re unsure of the underlying mechanisms at this point. But we believe some of the organisms of the infections in the oral cavity may be exposed to the fetus in utero.” This is suggested by the presence of antibodies to the infection in the babies’ cord and placental blood, which implies that the organism has spread from the mother to the fetus during pregnancy.

Dr. Ken Krebs, president-elect of the American Academy of Periodontists, also reports that a study implies a possible relationship between periodontal disease and development of preeclampsia, a dangerous disorder affecting five to eight percent of pregnancies.

Pregnant women are at higher risk for developing gum disease than the general public, explains Dr. Krebs, “simply because of hormonal changes: tissues tend to react more severely to the irritations that are present.” So while a non-pregnant person’s bacterial levels may be identical to a pregnant woman’s, the non-expectant woman may not develop the condition and the pregnant woman will. The hormone changes cause sensitivity and can lead to greater incidence of gum disease.

Could You Have Gum Disease?

Though the ADA states gum disease can be painless, the single best indicator of whether you have gum disease is still how your mouth feels. Several symptoms a person with periodontal disease may experience include:

Gum soreness

Gum redness

Bleeding when brushing or flossing

Persistent bad breath

“I think it’s critical that pregnant women pay more attention to their gum tissues,” says Dr. Krebs. “So many people think that if they have a little bit of bleeding that that’s normal. And it doesn’t upset people. But if you took the brush and rubbed it across your hand and your hand started to bleed, that would probably upset you.” Because it happens frequently for some people, they don’t remember a time when their gums didn’t bleed. But “it’s not really a normal occurrence; if someone has any bleeding at all when she brushes or flosses her teeth, that should be a pretty good indicator that she should seek professional help,” adds Dr. Krebs.

To protect yourself and your unborn baby, consider your answers to the following questions, provided by the American Academy of Periodontists:

Do you ever have pain in your mouth?

Do your gums ever bleed when you brush your teeth or when you eat hard food?

Have you noticed any spaces developing between your teeth?

Do your gums ever feel swollen or tender?

Have you noticed that your gums are receding (pulling back from your teeth) or your teeth appear longer than before?

Do you have persistent bad breath?

Have you noticed any change in the way your teeth fit together when you bite?

Do you ever develop sores in your mouth?

If you answered yes to any of the above questions, schedule an appointment with your dentist. He or she may refer you to a periodontist, who will work in conjunction with your regular dentist to treat your condition.

There can be high risks associated with permitting the condition to continue without proper professional treatment; however, gum disease caught in its early stages can often be treated with a simple office cleaning. If you are concerned about your oral health, you can find a periodontist near you by contacting the American Academy of Periodontology, and preferably before you are even pregnant. By taking care of your smile, you can help provide your baby with an excellent chance for a safe arrival.

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